Physician Assistant Details Importance of AE Management in Follicular Lymphoma

Depending on the grade of toxicity, clinicians will determine which course of action is best to treat it. Jennifer L. Garson, PA-C, suggested one way to manage adverse effects (AEs) is to dose reduce, although such a strategy may also compromise the clinical responses that a patient has already obtained.

Garson, a physician assistant from Rush Health in Chicago, spoke with CancerNetwork^® during an Around the Practice^® filming which focused on the current treatment options for follicular lymphoma.

Transcript:

We have patients who are on therapies, and one of our biggest challenges is how we manage any AEs. We all know that, with any medication, there is potential for AEs. In patients who have low-grade AEs, where it maybe isn’t disrupting their quality of life, it’s usually a tolerable AE. We don’t do a whole lot outside of maybe supportive care if there’s mild nausea. We may have to prescribe some medication for nausea if they’re having muscle cramping or some of these other myalgias we can see with it. It’s more about the supportive care in that.

It’s when we get to the grade 3/4 toxicities that it becomes a little bit more difficult to manage because you are stopping therapy, waiting for some of those toxicities or AEs to resolve before potentially restarting the therapy. When you do restart it, you’re looking at dose reductions.

When you do dose reductions, there’s going to be some compromise in your overall response rates and your duration of response. There are always those challenges. In doing that, it’s educating the patient about what they’re looking for [in] teasing out those AEs. Some AEs could be manifested by something other than medication. Looking at that, and trying to figure out the best way to keep a patient on an overall well-tolerated drug in the setting of some of these minor AEs, is a whole lot easier than looking at these grade 3/4 toxicities and moving into the next treatment.